Dear John: Dr John Briffa

For the past three years, blood tests have revealed that there is a problem with my liver. In March, a biopsy showed that I have a 'fatty liver'. Are there any natural approaches to dealing with this problem?Peter Askew, Barnet

Fatty liver is characterised by the accumulation of fat in the liver. It can be associated with an excessive intake of alcohol. When this is not the case, it is termed 'non-alcoholic fatty liver disease'. NAFLD seems to be common in individuals suffering from metabolic syndrome (or Syndrome X), which has several features, including excess weight around the waist and midriff (abdominal obesity), high blood pressure and raised levels of the blood fats cholesterol and triglycerides. It is associated with excesses of the hormone insulin, one biochemical effect of which is to stimulate the liver to make fat. In addition to keeping your alcohol intake to a minimum, eat a diet low in foodstuffs which stimulate surges in insulin such as biscuits and soft drinks, and starches such as bread, potatoes, rice and pasta. Exercise also helps to moderate insulin levels.